HomeMy WebLinkAboutHead, Graham
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ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION.OFFI~ER
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Town Ha~~~t:!n Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
Boutholdtown.northfork. net
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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TO: Gs:t2l&lutRdfd1Own Building Department
FROM:
Linda J. Cooper, Southold Town Clerk's Office
DATED:
Transmitted herewith is a copy of application No. 3548 for a Cesspool/Septic Tank Construction
Permit submitted by:
Matt D. Ivan
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit
Please complete the form below and return it to me.
Linda J. Cooper
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APPROVE
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I have reviewed the application and location map of the project cited above and make the following
recommendations:
DISAPPROVE
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Signature
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Dated t /
I!-IO -f/S- - ()oS:1..
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ELIZABETH A. NEVILLE -
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
^Town Hall, 63095 Main Road
P.O. Box "79
Southold, New York 11971
Fax (631)765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOU1HOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential@ $IO~ Non-Residential@$25 Application No. 2>5L/~
f PennitNo.
ApplicantNamek D. IV4"f- "f(oL/f-{"Vlto~AI-~fUc.TI~IIAlc..
ApplicantMailingAddress.:?'O.:boX 2fX)3i~'f'nt~.llWf1rDNI NbJ I~t- 11152-
Septic Tank kesspool_
Brief Description of Proposed Construction or Alteration_
1t.fYitJ.!iEl> Sw'W'A\,.t::; 1'~ ,,'P.&T/o; ~U>C4\E.. 5A"lT.~ fjf~M.. (~~)
Location of Proposed Construction! Alteration:
Owner of Property: G'~ l!U.b
OwnerMailingAddress:_55 iJu.a. ~~ #r. ~. NtJI 1lIt~ iii lOaf!,
Owner Property Address:, Il (,0 !It: &a:K..iMEi ~"",oc..P I ilY /I 7/
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Name and phone number ofcontactperson NI;tTD. IV6/.JJ~ ~~0.s3 7-f'/l:L::>
Tax Map No: /tpo Section 18 Block tJ8 Lot 005./
Cross Street ~ 'b4.1 'lta/1ZoAb
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVE~ HEALTH DEPARTMENT APPROVAL
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Isi~ of Applicant rue
Receivedby: V~-
Suffolk Environmental Consulting, Inc.
Newman Village, Suite E, 2322 Main Street, P.O. Box 2003, Bridgehampton, New York 11932-2003
(631) 537-5160 Fax: (631) 537-5291
Bruce Anderson, M.S., President
Hand Delivered
December 8, 2005
Damon Rallis, Plans Examiner
Southold Town Building Department
P.O. Box 1179
Southold, NY 11971
Re:
Situate:
SCTM #:
HEAD Application
1160 Goose Creek
Town of South old, NY
1000 - 078 - 08 - 005.001
Dear Mr. Rallis,
As per our telephone conversation this afternoon regarding the above referenced property,
please find attached:
(I) Town of Southold Wastewater District Application;
(2) Location Map of subject property; and
(3) Check made payable to the Town of South old.
By way of this correspondence, and on behalf of Mr. Head, kindly issue the requested
permit at your earliest opportunity. Should you have any questions concerning this
matter, please feel free to contact this office at any time. Thank you in advance for your
attention and consideration.
Sincerely,
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Matt D. Ivans
attachment
cc: G. Head
.
HEAD Property
Situate: 1160 Goose Creek Lane; Bayview; Town of Southold, NY
SCTM #: 1000 - 078 - 08 - 005.1
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